遺伝子研究の結果は決定的なものではなく、重要性が不確かな変異体の場合は、その意味を明らかにするためにさらなる研究が必要です。

患者の表現型を詳しく検討します (詳細な表現型解析)。
  • 小児年齢における遺伝性疾患の表現型は時間の経過とともに変化する可能性があるため、臨床追跡調査により将来、変異を再分類できる関連情報が得られる可能性があります。
  • 遺伝学研究室による病原性の解釈では標準化された表現型コーディングシステムが使用されるため、 HPO 規約 説明のために、遺伝学者に分析のためのより多くの情報を提供します。
家族分離調査を実施します。

家族分離を研究すると、次のようないくつかの結果が得られる可能性があります。

親の研究により、この変異体が新規であることが確認されました。

親族が無症状の場合、以前に同様の表現型に関与していた常染色体優性遺伝遺伝子またはX連鎖遺伝遺伝子におけるde novo変異体(親子関係が誤って帰属される可能性を排除できる生化学的親子関係の確認を伴う)が検出されると、その病原性が強化される。ただし、すべての人がゲノムに約 80 ~ 100 個の新規変異を抱えており、そのうち 1 ~ 2 個がエクソームで見つかる可能性があることを覚えておく必要があります。

親の研究により、この変異体が無症候性の親から受け継がれたことが確認されました。

状況によっては、変異が無症候性の親から受け継がれたことを証明することで、その良性が強化される可能性があります。ただし、この情報は、特に可変の浸透率を示す常染色体優性遺伝の遺伝子では注意して解釈する必要があり、その場合、この情報は病原性分類を変更しません。

親の研究により、変異体が家族内の表現型と分離することが確認されました。

実際には、大規模な家系図があり、影響を受けている人と影響を受けていない家族の複数のメンバーを数世代にわたって研究することができた場合を除き、両親の研究だけを行った場合、その発見が偶然に生じたものではないことを証明することは困難です。

親の研究により、この変異体が以前に同定された病原性変異体とトランスであることが確認されました。

関与する遺伝子が常染色体劣性遺伝であり、2 つの遺伝的変異が見つかったが、それらのうちの 1 つだけが病原性または病原性の可能性があると分類できる場合は、家族調査を実行して 2 つの可能性のある結果が得られると役立つ可能性があります。

  • 各変異は親から受け継がれており(したがって、インデックスケースではトランス型で見つかります)、常染色体劣性遺伝と互換性があります。
  • 両方のバリアントは同じ親から受け継がれています(そして、シスで、つまり、インデックスケースでは同じ対立遺伝子で見つかります)。この場合、見つかったバリアントは常染色体劣性遺伝パターンの原因ではありません。
Estudios bioquímicos, estudios funcionales y estudios de expresión de RNA.
  • 先天性代謝異常の場合のように、同定された遺伝子にバイオマーカーがある場合、 指示された生化学的調査、酵素研究として、同定された変異体が生体内で影響を与えることを実証する。
  • En caso de que esto no sea posible, y se sospeche que la localización de la variante puede condicionar consecuencias sobre el splicing o la expresión del RNA, pueden realizarse estudios de secuenciación del RNA para confirmarlo.
  • 基礎研究グループがある、または基礎研究グループと連携しているセンターでは、バイオシミラー生物、ノックアウト、またはその他の実験技術に関する機能研究を実施できます。
データベースを定期的に再分析します。

遺伝的変異を分類するプロセスは動的であり、分析時に入手可能な情報に依存しますが、一定期間後に再分析が実行された場合、解釈の変更を条件付ける可能性のある情報が急速に蓄積されます。重要性が不確かな変異体の 10% は 2 年後の再解析で再分類され、病原性またはおそらく病原性となる可能性があると推定されています。

いくつかあります 現在の分類を確認するためのツール 更新されたデータに基づく VSI の。

以前の病原性分類によっても、確率は等しくありません。

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Karbassi I, Maston GA, Love A, DiVincenzo C, Braastad CD, Elzinga CD, et al. A Standardized DNA Variant Scoring System for Pathogenicity Assessments in Mendelian Disorders. Human Mutation [Internet]. 2016 [cited 2022 Sept 22];37(1):127–34. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1002/humu.22918
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Nothing’s for sure, that’s for sure: Evaluating variants of uncertain significance | Beyond the Ion Channel [Internet]. 2022 [cited 2022 Sept 22]. Available from: http://epilepsygenetics.net/2016/08/11/nothings-for-sure-thats-for-sure-evaluating-variants-of-uncertain-significance/